Optional Features (Employee-paid)

*Selection of these plan options by an employee will require Medical Underwriting.

Definitions

Long Term Care Facility: This type of facility is an institution that is licensed or certified as a nursing home (if licensing or certification is required) or operates under the law as a nursing home, to provide skilled, intermediate and custodial care under the orders of a Physician and under the supervision of professional nurses.

Professional Home Care (PHC): Includes visits to your home by a licensed Home Health Care Provider during which skilled nursing care, physical, respiratory, occupational, dietary or speech therapy, or homemaker services are provided; Adult Day Care; or Hospice Care. The PHC benefit is equal to 75% of the Long Term Care/Facility Monthly Benefit Amount.

Total Home Care: Includes visits to your home by a licensed Home Health Care Provider to provide skilled nursing care; physical, respiratory, occupational, dietary or speech therapy, and homemaker services; Adult Day Care; Hospice Care; or care provided by an informal caregiver, such as your friends or relatives.

Assisted Living Facility (ALF): An institution that is licensed by the appropriate agency (if required) to primarily engage in providing ongoing care and services to a minimum of 6 residents in one location and operates under state licensing laws and any other laws that apply.

Respite Care: Care provided to you for a short period of time to allow your informal caregiver a break from his/her caregiving responsibilities.

Monthly Benefit Amount: This is the benefit amount Unum will pay monthly once you qualify for benefits and after the Elimination Period has been satisfied. The benefit paid is subject to the Lifetime Maximum Benefit Amount. Benefits are not paid during the Elimination Period.

Benefit Duration: This is the length of time benefits will be paid as long as you continue to be Disabled. You may move between facility and home care - depending on the need - and still receive benefits. You will continue to receive benefits as long as you qualify and until your Lifetime Maximum Benefit Amount has been completely used.

Lifetime Maximum Benefit Amount: This is the maximum benefit dollar amount Unum will pay over the life of your coverage. This dollar amount is based on the Long Term Care Facility Benefit Amount and the Benefit Duration (3 years, 6 years or unlimited) you elect.
For example: If you choose a $3,000/month Facility Benefit Amount and a 3 year Benefit Duration, your Lifetime Maximum is as follows:

$3,000/month x 12 months x 3 years = $108,000

Note: If you choose the "Unlimited" Benefit Duration, your Lifetime Maximum Benefit Amount will also be "Unlimited."

Elimination Period (EP): The EP is a period of 90 consecutive days of continuous Disability (that occurs after the effective date of coverage) and during which you are receiving care. This 90-day period must be satisfied before benefits begin. This 90-day EP must be satisfied only once during your lifetime.

Inflation Protection: Compound Growth Uncapped. If you choose this benefit, your Monthly Benefit will increase each year on January 1st by 5% of the original Monthly Benefit. Your remaining Lifetime Maximum Benefit Amount will also increase. Increases will be automatic and will occur regardless of your health and whether or not you are Disabled. Your premium will not increase due to automatic increases in your Monthly Benefit. The benefit paid is subject to the Lifetime Maximum Benefit Amount. Benefits are not paid during the Elimination Period.

Guarantee Issue for Employees: Guarantee Issue means that employees who purchase this insurance during their eligibility period can do so without having to answer questions on a medical questionnaire (medical underwriting). However, if you choose the Unlimited Benefit Duration, or wait to purchase coverage until after the initial enrollment period, medical underwriting will be required.

Medical Underwriting: All eligible family members are required to complete an Application for Long Term Care Insurance (medical questionnaire) for all choices. Medical Underwriting means that questions on a medical questionnaire must be answered. After the questionnaire is completed, it must be returned to Unum's Long Term Care Department. Unum will then determine eligibility and notify you when your coverage is effective.

Features

Guaranteed Renewable: As long as you pay your premiums on time, your coverage can never be canceled.

Waiver of Premium: Once you qualify for benefits and satisfy your Elimination Period and are receiving benefits, we will waive your premium payments.

Tax-free Benefit: This plan is tax-qualified, therefore, the benefits you receive from Unum are tax-free (subject to certain per day limitations).

Limitations and Exclusions

This policy has limitations and exclusions which may affect any benefits payable.

Unum will not make long term care payments to you for: a Disability caused by war (whether declared or not) or any act of war; a Disability caused by attempted suicide (while sane or insane) or self-destruction; a Disability caused by a commission of a crime for which you have been convicted under state or federal law or attempting to commit a crime under state or federal law; Disabilities or confinements during which you are outside the United States, its territories or possessions for longer than 30 days; a Disability caused by alcoholism or alcohol abuse; a Disability caused by voluntary use of any controlled substance unless the controlled substance is prescribed for you by a Physician ("Controlled substance" is defined in Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970 and all amendments); or a period in which you are confined in a hospital other than if you are confined in a nursing facility that is a distinctly separate part of a hospital (this exclusion does not apply to those periods covered under the Bed Reservation Benefit); or a Disability caused by psychological or psychiatric or mental conditions, regardless of cause, which include: depression, generalized anxiety disorders, personality disorders, schizophrenia, manic depressive disorders, or adjustment disorders and other conditions that are usually treated by a mental health provider or other qualified provider using psychotherapy, psychotropic drugs or similar methods of treatment.

However, Unum will make payments to you for conditions that are not psychological, psychiatric or mental in nature, including Alzheimer's disease or similar forms of irreversible dementia.

Pre-existing Conditions Exclusion

If you do not have to complete an Application for Long Term Care Insurance, which includes evidence of insurability, a pre-existing conditions exclusion may apply to you.

A pre-existing condition means any condition that exists for which you received medical treatment, consultation, care or services, including diagnostic measures for the condition, or took prescribed drugs or medicines during the six months right before your coverage began. Unum will not make any payments to you for a Disability that is caused by, contributed to by, or results from a pre-existing condition, and begins during the first six months after your coverage begins.